Liver

Question 1

most common class for acute liver failure

Answer 1

antibiotics

amoxclav

Question 2

liver functions

Answer 2

protein synthesis - clotting factors
bile secretion
biotransformation and detoxification
regenerative organ

Question 3

metabolic induced liver toxicity

Answer 3

oxidative stress

mitochondria

Question 4

immune mediated liver injury

Answer 4

immune reaction
ADCC
CDC

Question 5

factors that affect drug toxicity

Answer 5

age: poor IS so harder to have immune response
gender
diet - caffiene, alcohol
diseases- diabetes, hepatic, renal
enzyme polymorphism
drug drug interference

Question 6

signs of direct hepatotoxicity

Answer 6

expected, dose related
distinctive morphologic pattern
reproducible in animals
no extrahepatic signs of hypersensitivity 
serum enzyme elevations
likely oxidative stress mediated

Question 7

signs of acute hepatic necrosis

Answer 7

sudden direct heaptic toxicity 
increased ALT, AP, and bilirubin 
ALT 
INR elevated 
rapid improvement

Question 8

signs of idosyncratic hepatotoxicity

Answer 8

unexpected outcome 
not dose related
rare
variable lesions
not reproducible in animals
hypersensitivyt signs

Question 9

idosyncratic hepatotoxicity likely due to

Answer 9

immune mediated - rash fever

Question 10

idiosyncratic phenotypes

Answer 10

acute hepatitis
hepatocellular
cholestatic
mixed

Question 11

cholestatic vs hepatocellular hepatotoxicity

Answer 11

R>5 = hepatocellular 
R<2 = cholestatic
R=2-5 = mixed
r = ALT/AP

Question 12

describe indirect toxicity

Answer 12

meds induce or alter a preexisting liver condition
can be predicted or avoided
reactivate hep B or C

Question 13

phenotypes of indirect hepatotoxicity

Answer 13

acute hepatitis
acute liver failure
chronic hepatitis
fatty liver

Question 14

phenotypes of drug induced liver injury

Answer 14

a whole shit ton

Question 15

diagnosing phenotypes of drug induced liver toxicity

Answer 15

histological
clinical
labratory
noninvasive imaging

Question 16

symptoms to prompt testing for liver injury

Answer 16

fatigue
nausea
anorexia
maliase
right upper abdominal pain
jaundice

Question 17

treatment of drug induced liver injury

Answer 17

stop causative agent

Question 18

what does hy’s law suggest

Answer 18

jaundice that appears after drug induced hepatocellular injury = serious problem
mortality rate >10%

Question 19

hy’s laws

Answer 19

drug causes alanine transaminase>3xULN more than placebo
total bilirubin>2x ULN
no other reason can be found to explain the combo of increased AT and TBL

Question 20

alcohol liver disease

Answer 20

alcohol level
history of alcohol use
ration of AST to ALT 2:!

Question 21

diagnosis of viral hepatitia

Answer 21

hep A, B, C, or E antibody

Question 22

diagnosis of hemodynamic liver disease

Answer 22

hypotension
shock
heart failure
vascula occlusion

Question 23

what is happening in this lecture

Answer 23

no damn clue